Flat Nipples and Breastfeeding

By Carrie Bruno

April 17, 2019

Carrie is the founder of The Mama Coach. She is a RN, IBCLC lactation consultant, sleep consultant and mama of two little guys. She leads the nationwide team of Mama Coaches and is committed to making motherhood easier.

Breasts and nipples come in all different shapes and sizes and if you have never breastfed before, you might be wondering if the anatomy of your breast is going to affect your ability to breastfeed.  When it comes to flat nipples, try to remember that babies don’t nipple feed, they breastfeed! Although some nipple shapes and lengths can make it more difficult to latch baby onto the breast, the shape and size of the nipple is much less important than baby getting a good wide mouthful of breast!

What are true flat nipples?

If you think you may have flat nipples, two simple ways to tell include gently compressing the areola about an inch behind the base of the nipple and stimulating your nipples with a cold moist cloth or ice.  If the nipple does not become erect or protrude outwards, then this is considered a flat nipple. Some nipples may even retract or become concave when the areola is gently compressed and this is considered an inverted nipple.  

What if my nipples were protruding during pregnancy but postpartum they seem flat?

Postpartum, you might be surprised that your nipples have changed and look a lot flatter, but what you may be seeing is swelling due to breast engorgement or the large amounts of IV fluid you may have been given during labour.  This situation can make if difficult to latch baby onto your breast and the best thing to do is to treat the engorgement. Check out our Mama Coach article here on how to relieve engorgement.

Can I still breastfeed with true flat or inverted nipples?

Depending on your situation, in most cases the answer to this is yes, but you may need some extra breastfeeding support from a skilled health professional postpartum.  

First and foremost, help with the basics of positioning and latch can be of real benefit if you have flat or inverted nipples as both will help baby to open their mouth really wide, pass right over the nipple, and close their gums further back on the breast.  Certain breastfeeding positions such as the football hold and cross-cradle hold can really give you more control and make it easier for baby to latch on well. These positions also allow you to create a C-hold on your breast with your hand, so you can push your breast in towards the chest to help the nipple protrude during a feed.

It can also really help to breastfeed as early and as often as possible after giving birth, not only to avoid engorgement which can make breastfeeding even harder, but also to give you time to practice breastfeeding while your breasts are soft.  Unfortunately, this is not always possible. Try though not to get disheartened, as what is not possible on day 3, may well be possible days or even weeks later. The key is getting the support you need to help you on your breastfeeding journey.

What other things can I try if I have flat or inverted nipples postpartum?

  • Stimulate your nipples for a few minutes before feedings by either rolling your nipple between your thumb and finger or very quickly touch your nipple with a cool moist cloth or ice.  
  • Hand express milk before feeding onto the nipple to try and entice baby to latch on.
  • Use a breast pump before feeding to soften the areola and draw the nipple out.

What if none of this helps?

Don’t give up hope! For some mamas the use of a nipple shield can provide the stimulation baby needs to open their mouth wide, latch on and nurse well.  If you do want to try a nipple shield, it is highly recommended that you seek the support of a Lactation Consultant or Counselor to ensure its proper use and that you take steps to ensure your milk supply is maintained.

If you need help with breastfeeding postpartum or want to learn more about breastfeeding prior to baby’s arrival don’t hesitate to reach out to your Local Mama Coach.

 

References
La Leche League International, The Breastfeeding Answer Book, 3rd Edition.
Dr Jack Newman’s Guide to Breastfeeding, Revised Edition, 2014

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